DR. CARROLL A CRADOCK (NPI# 1316085954) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1316085954 |
Entity Type | Individual |
Full Name | DR. CARROLL A CRADOCK |
Credential | PH.D. |
Practice Address |
411 S Sangamon St Suite 2a Chicago IL 60607-3547 |
Practice Telephone | 3122437441 |
Mailing Telephone | 3122437441 |
Enumeration Date | 2007-02-04 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | Y |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
X | 103TC2200X |
Psychologist Specialization: Clinical Child & Adolescent |
Behavioral Health & Social Service Providers | ||
X | 103TC0700X |
Psychologist Specialization: Clinical |
IL | Behavioral Health & Social Service Providers |
Street Address |
411 S SANGAMON ST SUITE 2A |
City | CHICAGO |
State | IL |
Zip Code | 60607-3547 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1992349237 | Portia Dowd | Registered Nurse | 140 N Ashland, Chicago, IL 60607 | 2019-10-30 |
1114577210 | Joseph Matthew Thiel | Emergency Medical Technician, Intermediate | 558 West De Koven, Chicago, IL 60607 | 2019-09-19 |
1215585757 | Highland Park Cvs LLC | Durable Medical Equipment & Medical Supplies | 1034 West Lake St, Chicago, IL 60607 | 2019-08-28 |
1003462821 | Michael Marek Maka | Psychologist | 820 W. Jackson Blvd, Suite 515, Chicago, IL 60607 | 2019-08-16 |
1558922344 | Kellie Meyer | Speech-Language Pathologist | Eyas Landing West Loop, 1409 W. Carroll Ave, Chicago, IL 60607 | 2019-06-24 |
1811460108 | Corinna House | Social Worker | 932 W Washington, Chicago, IL 60607 | 2019-01-09 |
1962979518 | Louise Taussig Bush | Counselor | 1142 West Madison Street, Suite 406, Chicago, IL 60607 | 2018-10-31 |
1568941318 | Walgreen Co | Durable Medical Equipment & Medical Supplies | 1051 W Randolph, Chicago, IL 60607 | 2018-08-13 |
1851883425 | Alefiyah Zulfiqar Pishori | Psychologist | 1200 West Harrison St, Chicago, IL 60607 | 2018-05-30 |
1679062954 | Elizabeth R Rolston | Physical Therapist | 24 S Morgan St Ste 100, Chicago, IL 60607 | 2018-05-02 |
Find all providers in zip 60607 |
Taxonomy Code | 103TC2200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Clinical Child & Adolescent |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1235647470 | Laurie Gayes Thompson | Psychologist | 225 E Chicago Ave # 2, Chicago, IL 60611-2991 | 2018-01-22 |
1558874891 | Claire Ashling Coyne | Psychologist | 225 E Chicago Ave # 10b, Chicago, IL 60611-2991 | 2017-11-08 |
1659721967 | Micah Ioffe | Psychologist | 1300 W Belmont Ave Ste 501, Chicago, IL 60657 | 2016-06-16 |
1609243856 | Humboldt Behavioral Health Group | Psychologist | 3317 W Le Moyne St, Chicago, IL 60651-2452 | 2015-08-24 |
1659610491 | Alexandra M Psihogios | Psychologist | 1110 W Columbia Ave, Apt 1n, Chicago, IL 60626-4522 | 2013-02-13 |
1265781934 | Anthony Thomas Vesco | Psychologist | 225 E Chicago Ave # 10a, Chicago, IL 60611-2991 | 2012-09-10 |
1689951519 | Jesse Klein | Psychologist | 639 W Diversey Pkwy Ste 207, Chicago, IL 60614-1535 | 2011-11-06 |
1639357486 | Victor J Bernstein | Psychologist | 2045 W Waveland Ave, Chicago, IL 60618-4949 | 2008-02-04 |
1114113487 | Bradley C Stolbach | Psychologist | 6700 S. Promontory Drive, Chicago, IL 60649 | 2007-09-20 |
1023227469 | Thomas F. Barrett | Psychologist | 1030 N. Clark St., Suite 303, Chicago, IL 60610 | 2007-05-22 |
Find all providers in CHICAGO |
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Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.